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CMS-1403-FC
(a) Physicians, nonphysician practitioners and
physician and nonphysician practitioner organizations may
retrospectively bill for services when a physician or
nonphysician practitioner or a physician or a nonphysician
organization have met all program requirements, including
State licensure requirements, and services were provided at
the enrolled practice location for up to--
(1) 30 days prior to their effective date if
circumstances precluded enrollment in advance of providing
services to Medicare beneficiaries, or
(2) 90 days prior to their effective date if a
Presidentially-declared disaster under the Robert T.
Stafford Disaster Relief and Emergency Assistance Act, 42
U.S.C. §§5121-5206 (Stafford Act) precluded enrollment in
advance of providing services to Medicare beneficiaries.
(b) [Reserved]
45. Section 424.530 is amended by--
A. Revising the section heading as set forth below.
B. Adding paragraphs (a)(6) and (a)(7).
The revision and additions read as follows:
§424.530 Denial of enrollment in the Medicare program.
(a) * * *
(6) Overpayment. The current owner (as defined in
§424.502), physician or nonphysician practitioner has an
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